CHL TERMS AND CONDITIONS

The terms and conditions of business apply to services carried out by CURIS HEALTH LTD

1. DEFINITIONS

1.1. “CHL”, “Company”, “We” and “Us” here refers to Curis Health Limited and its Agents, company number 14716318.

1.2. “Patient Information” here refers to personally identifiable information referencing a natural person who wishes to engage with CHL for services. This information may be clinical or clerical in nature and may be supplied/collected orally, in brochures, letter form and/or electronic communication.

1.3. “Procedure” here refers to the intended medical procedure(s) to be carried out by a surgical team, under the direct care of Consultant(s) engaged by the Patient, who hold(s) a ‘practicing privileges agreement’ or Surgeon/Anaesthetist contract or is in some other way permitted to carry out medical procedural activities at CHL premises. Patients attending external facilities will contract with that facility for the in-Patient episode which would usually include a Consultant Surgeon and Consultant Anaesthetist.

1.4. “Consultant Surgeon”, “Surgeon”, “Admitting Practitioner”, “Consultant Anaesthetist” and “Anaesthetist” here means the registered medical professional(s) ultimately responsible for patient care and registered with the General Medical Council.

1.5. “Patient” here means any person who has entered into a contract with CHL for the services advertised, or any person who engages with CHL with the intention of entering into a contract for services with CHL, and whom CHL have accepted.

1.6 “Non-surgical aspects of a procedure” here means the services provided by CHL, namely the provision of the premises; the theatre and the preoperative assessment and with CHL for the post-operative nursing care. It does not include the pre-operative and post-operative consultation and/or advice and/ or treatments (which include decisions on medication and discharge of the Patient), which remain with the appropriate Admitting Practitioner. Patients attending external facilities will contract with that facility for the in-patient episode.

1.7. “Pre-booking” means a booking and payment made prior to consultation with a Surgeon. A pre-booking is not a guarantee of patient suitability for a specific surgical plan and is purely a hold placed to secure surgical diary space.

1.8. “Surgical cover” means the post-operative care and support provided by CHL and the Admitting Practitioner included within the cost of the procedure.

1.9. “Cost” is total price for services as detailed on the quotation.

1.10. “Consultation” here means:

1.10.(1) A meeting between the Patient and the Surgeon, at which the Patient’s condition, expectations and motivations are reviewed, a treatment plan is devised to address condition, and suitability for that procedure is considered.

1.10.(2) A meeting between the Patient and the Surgeon to review the outcome of a surgical intervention, with or without the provision of further treatment.

1.10.(3) Appointments with Patient Care Co-ordinators (PCC) and/or any members of CHL staff are intended to support the intended surgical journey by information gathering and supporting the Patient to make an informed choice about the procedure. The PCC and/or member of staff is unlikely to be a doctor and any advice they give should, in any event, be regarded as purely of a general non-medical nature. For avoidance of doubt, these appointments are NOT considered as a consultation.

1.11. “Premises” means any hospital, clinic, or other building, or part thereof, under the ownership, occupation, or management of CHL.

1.12. “External facilities” are those not owned, under the control of, or management by CHL.

1.13. “Further surgery” refers to additional surgical interventions performed following the original operation, which is either included in the original costs paid, or when additional fees are charged.

2. OBLIGATIONS AND WARRANTIES

2.1. CHL warrants that before inviting a Surgeon or Anaesthetist to receive practicing privileges rights or a Surgeon’s/Anaesthetist’s contract permitting the said person to practice at CHL premises (and before re-issuing these intermittently thereafter), CHL confirms that the person is registered with the General Medical Council, will undertake relevant due diligence checks on background and surgical fitness to practice, and ensures that CHL has seen a copy of a private practice indemnity insurance cover certificate which is current at the date of granting practicing privileges rights, or a contract, or other such agreement which permits him/her to practice such procedures. CHL does not usually obtain copies of the whole of the private practice medical indemnity insurance policy document and nor does it make any warranties in respect of the content of the same, save as set out above. Patients attending external facilities should ensure that the facility they are attending holds this documentation in respect of any practitioner who may attend to the Patient during the in-patient episode. CHL will display or make available GMC numbers of all Admitting Practitioners within their facilities.

2.2. All surgeons, as self-employed contractors, are themselves responsible for maintaining their revalidation and registration with the General Medical Council, keeping their surgical logbook updated, and maintaining full private practice medical indemnity insurance. It is recommended that the Patient independently checks the most up to date position with regards to the practitioner’s registration with the General Medical Council and his/her private practice medical indemnity insurance position before undergoing any procedure. CHL will make available clinician profiles to assist prospective Patients in making a choice of Surgeon based on their areas of clinical interest and experience – Patients are responsible for choosing their own Surgeon. Surgeons and Anaesthetists which CHL may from time to time introduce to patients are self-employed and, as such always make their own clinical decisions and are responsible for the outcome of surgery and the surgical aspects of the procedure.

2.3. Surgeon and Anaesthetist fees are included in the quoted price and CHL acts as their agents in the collection of any monies falling due. The Surgeon, Anaesthetist and the Hospital may invoice patients separately, but the total will not be more than shown on the quotation. Surgeon fees may be applied or may vary where further surgery is required.

2.4. The Patient warrant no cause of action or vicarious liability will accrue against CHL for any surgical aspect of the procedure carried out by the Surgeon and/or Anaesthetists.

2.5. The Patient warrants that they will read the patient information provided to appraise themselves of the range of possible outcomes, risks and benefits of any proposed procedure(s).

2.6. CHL will provide all immediate post-operative medication required relevant to the procedure (i.e. antibiotics and painkillers) as prescribed by the relevant Surgeon or a Doctor; where the medicine is not included in CHL’s formulary (or the Patient has sensitivities requiring non-standard medication), a private prescription will be provided to the Patient and the fee for this prescription is the responsibility of the Patient. Patients attending external facilities will receive post-operative medication directly from the external facility. This medication does not include any medication required after the first 5 days post op-surgery unless this is a prescription medicine, required and prescribed by the medical practitioner. It may also not include specialist medication required, or medicine needed if the Patient has not adhered to post-operative instructions.

3. PATIENT’S OBLIGATIONS

3.1. This contract is conditional upon the acceptance of the Patient by the Surgeon and/or Anaesthetist based upon information given by the Patient during the consultation, and collection of further relevant medical information provided by other Healthcare Providers. The decision to carry out any surgical intervention shall be at the discretion of the Surgeon, the Anaesthetist and CHL.

3.2. The Patient warrants that they will read all information provided to fully understand the range of possible outcomes of the proposed procedure.

3.3. The Patient agrees to comply with all post-operative instructions – including attending for the requisite number of post-operative care appointments and abstaining from activity that could reasonably be known to prejudice the surgical outcome.

3.4. The Patient agrees to inform CHL if they have concerns with their care or clinical outcomes at any stage of their journey and offer CHL an opportunity to review, investigate and offer a resolution before publicising any information that could reasonably be known to bring the Company or the Surgeon into disrepute in a public domain (websites, personal social media accounts, review sites, general media and instant messaging). This does not include raising any concerns to regulatory bodies.

3.5. The Company will endeavour to provide aftercare at the nearest geographical CHL location to the Patient. Where this is not possible or appropriate (due to care required), the Patient agrees to attend appointments at an alternative CHL clinic or hospital.

3.6. The Patient accepts that any failure to comply with section 3.3 above, including attempts at self-care (that have not been accepted as part of the care plan), or choosing to manage routine aftercare with an alternate provider could prejudice the surgical outcome and may result in the removal of the 12-month surgical cover provided by CHL. (Aside from aftercare required to bring the episode of care to a safe end.) This does not apply to suitable emergency care sought out of hours, or at the suggestion of CHL or the Surgeon.

3.7. The Patient accepts that clinical staff may not be available 24/7 therefore calls and appointments will be offered subject to staff and clinic availability.

3.8. The Patient understands that the Company may decline to proceed with surgery if a Patient is not prepared to provide medical information to allow an assessment of clinical risk to be created. This includes (but is not limited to) GP summary, specialist letters, investigations, results and supporting letters, and presenting for psychological assessments if requested.

3.9. The Patient understands that if they wish to change their surgery in any way (i.e. alter implant size or add additional surgery) that they must return to see their Surgeon and be consulted for these changes before their procedure date, normal terms and conditions apply, see section 5.

3.10. The Patient has the choice to waive their right to a 14-day clinical cooling off period.

3.11. The Patient has the right to self-discharge from hospital against clinical advice. If this is to occur, a disclaimer must be signed, accepting all risks and consequences.

3.12. The Patient acknowledges that their PCC is not a doctor or surgeon.

3.13. Any advice that the PCC may give is purely of a general non-medical nature. If the Patient has any queries, then these should be raised at consultation with the Surgeon, and/or Anaesthetist or other suitably qualified persons.

3.14. The Patient agrees to provide the Surgeon, Anaesthetist and clinical staff of the hospital with a health history that is honest, accurate, reliable and complete. The Patient understands that knowingly withholding any medical information that could be detrimental to their health and safety may result in cancellation of the procedure with no refund. The Patient agrees that if any change occurs in his or her medical history or status to inform CHL and the Surgeon and the Anaesthetist without delay and to keep CHL, the Surgeon, and the Anaesthetist informed.

3.15. Treatment will only be given where monies falling due have been received at least 30 days prior to surgery (or as soon as possible for surgery booked less than 30 days in advance, but always prior to surgery).

3.16. The minimum age for any consultation or surgical procedure is 18 years of age.

3.17. The Patient acknowledges that any consent they are signing is a confirmation that they understand the surgical intervention proposed, and agree that it should proceed. Consent may be withdrawn at any point prior to anaesthesia, however, should the patient be unsure of any aspect covered in the consent form, they should ask clarifying questions and be assured prior to proceeding with surgery.

3.18. The Patient agrees that the Company is not responsible for costs associated with any treatment that CHL or the operating Surgeon recommend but do not provide, such as ultrasound scans, or any other payable service that is recommended be provided externally.

3.19. The patient understands that CHL will not be vicariously liable for any treatment not provided by the Company.

4. GENERAL OBLIGATIONS

4.1. CHL reserves the right to alter the Patient’s admission date and/or outpatient appointments although such changes will be avoided wherever possible. The Patient agrees that no consequential loss will be payable for the short notice cancellation on any procedure/ appointment (including reimbursement for travel, tests, hotels).

4.2. The Patient agrees that in signing this set of terms and conditions and any pre-operative medical notes that he/she has understood the terms and has been given an opportunity to seek explanation. The pre-operative medical notes are designed to ensure there is a contemporaneous record that both the Patient and Surgeon are fully aligned as to the procedure that has been planned for before the operation and that the potential risks and benefits are understood. Patients must sign this form before surgery commences.

4.3. The Patient accepts that CHL’s liability for breach of contract is any way limited to the operation costs. The Patient and the Surgeon will be required to sign a medical consent form at the hospital prior to surgery.

4.4. The company reserves the right to cancel or postpone procedures. This decision must be a reasonable one and in the best interest of the Patient; in the event of late cancellations or movements, the company accepts no liability for any financial loss to the Patient and no reimbursements will be given.

5. RESCHEDULING

5.1. Rescheduling here refers to a cancelation of a planned surgical date, with a corresponding booking commitment made for a later date instead. If the Patient needs to reschedule surgery, the following fees may apply to offset against administration and losses incurred:

5.2. 28 days or more notice: £75

5.3. 27 to 14 days’ notice: £250

5.4. 13 to 6 days’ notice: £500

5.5. Less than 5 days’ notice: £1000

5.6. Patients must notify the company immediately if they are experiencing any symptoms of illness 5 days or less prior to surgery. CHL reserve the right to assess the Patient’s fitness for surgery and to reschedule any procedure on the grounds of temporary medical unsuitability following the disclosure or discovery of medical conditions/factors within 5 days of surgery, where proceeding with surgery on the scheduled date would likely increase risk to the Patient. In these instances, a fee of £1000 may be applied. Temporary medical unsuitability would include (but is not limited to) a positive pregnancy or nicotine test, discovery/disclosure of cold/flu symptoms and a change in Body Mass Index (outside of acceptable safety thresholds). If the Patient decides to cancel rather than reschedule, please refer to section 7 of the terms and conditions.

5.7. If upon arrival on the day of the procedure the Patient presents with symptoms of a potentially communicable illness (e.g. cold, cough, fever), the company reserves the right to reschedule the surgery for the safety of the Patient and medical team and retain all monies paid for that procedure.
This policy does not affect the 5-day period of reflection.

5.8. If a patient reschedules their surgery and books a new date which is later cancelled, CHL may determine the original surgery date as cancelled with cancellation fees applicable from the original date of surgery. Fees payable will be in line with sections 5.2-5.5 above.

6. CANCELLATIONS

6.1. Cancellation here refers to a cancellation of a planned surgical date, with no further booking made in replacement at that time. Cancellations are to be made in writing to Joseph House, 970 Stratford Road, Shirley, Solihull, B90 4ED. CHL recommend that patients consider all aspects of the procedure for at least 14 days after consultation with the Surgeon. Should the Patient wish to cancel after 5 days following consultation, the deposit paid is non-refundable. Any other monies paid for the procedure are fully refundable, with the proviso that the company has been notified by recorded or guaranteed post to Scheduling Department. Outside of this period, the following fees will apply to offset against administration and losses incurred.

6.2. Cancellations made over 2 weeks prior to surgery date/holding date – 25% of the total cost.

6.3. Cancellations made 8-14 days prior to date of surgery – 50% of the total cost.

6.4. Cancellations made 7 – 3 days prior to and including date of surgery/holding month – 75% of the total cost.

6.5. Cancellations made 3 days or less – full cost of surgery retained.

7. CANCELLATIONS FOR MEDICAL REASONS

7.1. Cancellations made necessary due to previously unknown medical conditions (temporary medical unsuitability) will be rescheduled where possible. If after reasonable consideration the indicated medical condition/medical factors prevent safe rescheduling of the procedure, then refund of the monies paid will be given in full to the Patient.

7.2. Cancellations due to pre-existing medical conditions which were known by the Patient but undisclosed prior to booking the procedure will be refunded in line with section 6.2 – 6.5 of these terms and conditions.

7.3. If the procedure is abandoned intra-operatively due to unforeseen medical conditions/factors, CHL will retain sufficient monies to cover the costs incurred by the Company as reasonably deemed fit and in accordance with these terms and conditions.

7.4. “Pre-booked” surgeries may be cancelled at any time prior to consultation and will receive a full refund including the deposit. Cancellations made after the 5-day period of reflection following consultation will be refunded in line with section 6 above.

7.5. Patients will receive a nicotine and pregnancy test on the day of surgery, should either test be positive, a fee may be charged of up to £1,000 to cover costs of lost surgical space.

8. COMPLAINTS & RE-ADMISSION

8.1. The complaints procedure is available on request from the PCC or via CHL’s website. If patients have a complaint regarding any aspect of care, outcome or treatment, it is recommended that this is discussed with the PCC in the first instance. The PCC may seek intervention from the Registered Manager or Patient Care Manager to help resolve complaints locally. If no resolution can be reached, the formal complaints process can be initiated. If after using CHL’s usual complaints process no resolution can be reached, CHL may refer the complaint for independent mediation. Referrals will be conditional on the basis that both parties are bound by the outcome. CHL may be responsible to fund the mediation. The Patient agrees that all medical records can be released to the appointed arbitration officer. Settlements reached using this method will be considered by CHL and the Patient as a full and final settlement or compromise agreement.

8.2. Complaints follow a 3-stage process, 2 stages internal and final stage independent adjudication; the final stage is not an option unless first two stages are signed off by the Company. Each stage will receive acknowledgment within 3 working days and a response within 20 working days of the date of your formal complaint or response (unless extended in writing). Patients have 6 months from the date of the company’s formal response to escalate the complaint. If at any stage legal advice is sought by the Patient, CHL reserves the right to pause the complaints process to seek their own legal advice. This does not affect the patient’s rights and upon CHL obtaining legal advice, the complaints process will resume unless legally advised against. During this time, updates will be provided on response time frames as per polices. A complaint must be initiated no longer than 6 months from the end of surgical cover or no longer than 6 months from the date the issue presented and was raised with the company.

8.3. The initial aftercare period will include standard postsurgical review appointments within the term specified on the personal quotation. CHL reserves the right to change the aftercare policy from time to time. In case of any doubt, the aftercare policy in force at the time of booking will be applied. CHL reserve the right to remove surgical cover if the Patient has failed to follow the terms set to them, but (where safe and appropriate to do so) will continue offering aftercare to safely bring the episode of care to a clinical end point.

8.4. CHL reserves the right to pause all further surgery pre-operative appointments, surgical interventions and surgical cover should the Patient decide to enter the formal complaints process or seek legal advice/ intervention. This does not affect patient’s rights, it is designed to protect both parties while an agreement is reached; once resolved, surgical cover will be resumed.

9. READMISSIONS / FURTHER SURGERY SECTION

9.1. Readmission – for up to 3 to 12 months after a surgical procedure, if both the Patient and Surgeon agree that further surgery (as part of the original procedure) is necessary to assist in achieving an improvement to the outcome, CHL and the Surgeon will consider contributing to the surgical and hospital costs. If, however, your Surgeon decides that the results of the surgical procedure are acceptable within the normal limitations and expectations set of surgery, then further surgery may incur the full fee. CHL will assess separately the circumstances of each patient in determining the basis on which further surgery may be provided. CHL will make the ultimate decision on further surgery and the Company’s decision is final. Further surgical procedures do not automatically provide the same aftercare time as the original procedure, please check with CHL on the period of cover that will be applicable when planning this. Further surgery may be also provided as part of a compromise agreement, there is a formal process and approval for further surgery and could take up to 28 days; if further surgery is approved and is free of charge, the company may not provide any garments and may not accept any financial losses to the Patient, which includes travel, tests and accommodation costs; A nominal theatre reservation fee will be payable to secure a further surgery date of £500, normal terms and conditions will apply to further surgery and rescheduling. (See 5.0).

9.2. If further surgery is required and approved during the period of surgical cover, the Company may ask the Patient to wait a period of time whilst their body is recovering – surgical cover is not affected by this requirement to undertake a “watchful wait” period, regardless of whether the wait period takes the Patient outside of the normal 12 months of cover.

9.3. If the Patient has further surgery approved, but wishes to modify this, or add another procedure whilst they are under anaesthetic; the Company can try to accommodate this based on clinical requirements and safety and costs may be added where required.

9.4. If the Patient fails to attend review appointments or follow advice and guidance given, or where the results of the surgery originally provided have been affected by changes in lifestyle, weight changes, illness or the natural ageing process, CHL will not commit to providing further surgery at a reduced cost.

9.5. CHL agrees that all matters relating to the Patient’s treatment will be kept as confidential save where CHL are required to disclose such material to relevant members of medical staff at CHL or other relevant providers and regulatory bodies.

9.6. The company adheres to UK data protection legislation, only sharing data where necessary. If a Patient decides to disclose their personal or medical details on a public forum, such as social media, general media, websites or instant messaging platforms; the company reserves the right to respond or comment on that disclosure, so long as no new unshared information is disclosed. If a Patient chooses to disclose information in a public forum and the Company believes this to be untrue or defamatory; the company reserves the right to respond to the information or contact the Patient privately to discuss the matter with a view to having any untruthful or defamatory content removed. This action may also invalidate any surgical cover. Defamation is an offence under the Defamation Act 2013 and the company may pursue resolution via the appropriate channels if necessary. If the Patient fails to adhere to section 3.4 of these terms in allowing CHL to address any concerns prior to publicising any information in a public domain, this may invalidate surgical cover.

9.7. The Patient confirms their consent to the disclosure of personal information by CHL to Surgeons, Anaesthetist’s and clinicians involved with the provision of their care and administration of their booking.

9.8. If required, your PCC will provide you with the policy on access to medical records.

9.9. As a Joint Data Controller, throughout your treatment journey your Surgeon may take clinical photographs that they hold within their own clinical records. Whilst CHL maintain copies of all clinical records supplied (and requests that Surgeons provide copies of all clinical photography to CHL), any records maintained solely with the Surgeon (including clinical photography) would need to be requested from the Surgeon in the event of a Data Subject Access Request, and CHL do not take any responsibility for the storage or retention of these records.

10 JURISDICTION

10.1. The laws of United Kingdom shall apply to this contract and the courts of United Kingdom shall have exclusive jurisdiction

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